Chioma Obinna
6 January 2009
Undoubtedly, there has been several attempts to effectively address the knowledge and skills deficit in the healthcare workforce in the country.
Unfortunately, these attempts have gulped so much resources that could not be imagined. However, medical experts have been searching for other ways to ensure a better skill as well as reduce the cost of acquiring these skills.
One solution presently, explored by cross section of Nigerian surgeons is to train healthcare workers in their local environment. This is not only less expensive, but allows modification of the training structure to suit the local environment, thus increasing the likelihood that such training will be effective.
One example of such training is the introduction of new surgical skills and technology by some group of Nigerian surgeons in conjunction with US based-physicians, a local physician group, Ghent Urology & Surgery (GU & S) and the Shawsand Medical Center, Eleme in Port Harcourt, Rivers State. The training was strictly on Laparoscopic Cholecystectomy.
While the US physician group was represented by Nigerian-born, Dr Fiemu Nwariaku, the Nigerian group was made up of the medical director of Shawsand Medical Center, Dr Leslie E Akporiaye. Surgeons from the Abia State University Teaching Hospital in Aba were on-site to observe the surgical procedure.
Laparoscopic Cholecystecotmy is the removal of the gallbladder through small 'keyhole' incisions using a camera or laparoscope. Importantly, the procedure does not require the conventional opening of the tummy by the surgeon During the training at the medical center, surgeons removed a patient's gallbladder through incisions measuring less than half an inch in length.
Also, known as "keyhole surgery" or minimal-access surgery, this procedure reduces hospital stay for surgical patients, and reduces the overall cost of medical care by allowing patients to return to their normal daily activities sooner.
While this is just one type of laparoscopic surgery, there are numerous examples of new surgical procedures and technology that will benefit the healthcare workforce and the overall population. Some of these include procedures such as arthroscopy and joint replacement, ultrasound-guided procedures, endoscopic gastroenterology and urology, laparoscopic removal of the uterus, prostate, colon, stomach, pancreas, spleen, and kidney amongst others.
According to reports, gallbladder surgery is one of the many ailments over which many Nigerians, especially the elite who can afford the costs, travel abroad to seek solutions. However, given the tremendous cost of seeking such care overseas, certain professionals in the industry believe that such programs could be performed at a fraction of the cost within Nigeria.
Commenting on the training, Dr Leslie Akporiye, said "If the Federal Government of Nigeria shares the vision of improving professional skill among healthcare workers and providing 'world class' medical care to its population, then the model of public-private partnerships for medical training is a viable, low-cost solution. The idea here is to draw attention to the fact that infrastructural development would serve a surviving humanity not a dying one"
Noting that the technology of 'key-hole' surgery is more than 20 years old elsewhere, he regretted that it has been part of the Nigerian medical experience in a few centers and for only a few years, Port Harcourt being the latest.
"The search for overseas solutions abroad by Nigerians who can afford the treatment is a major loss of foreign exchange for the country, whereas if these procedures are performed in the country, jobs will be created and the funds retained in the Nigerian economy. More importantly, many Nigerians who cannot afford to travel overseas may die.
It is interesting to note that practicing medical doctors, and not medical students, attended the session in Port Harcourt. This highlights the major deficit in our undergraduate medical education environment"
The visit by the team from the Abia State University teaching Hospital was facilitated by a consultant surgeon, Dr Adeyinka Adisa. All the doctors and other medical personnel, including nurses, laboratory hands etc, were as awed as the layman in the street.
We believe that this is a laudable effort by some medical professionals. The time has come for Federal and State governments to partner with private groups to raise the quality of our medical professionals. They share a responsibility to ensure a health population.
As the popular saying goes, 'Wealth through Health'. Skill and knowledge transfer in the medical sector in Nigeria is a vision that should not be allowed to die reach the Nigerian population (and improve health) much faster. As we now live in a global society, it would be unconscionable for Nigerians to be denied the medical advantages of new technology.
In fact, laparoscopic cholecystectomy was introduced in the rest of the world over 20 years ago, but is only now catching on in Nigeria.
In addition to the Shawsand Medical Center example, other efforts to introduce laparoscopy have been made by surgeons in Lagos, Kano, Ibadan and Abuja.
As the key-hole alternative become popular and new technologies are introduced into the surgical workplace in Nigeria, it is believed that the awareness for the skill transfer will become higher, and more organizations, including the government will recreate this model, thereby reducing the disparities in healthcare outcomes between Nigeria and Western countries.
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